MedicarePartD.guide

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2026 Wellcare Classic (PDP) formulary (drug list)

Contract S4802, plan 075 · New Hampshire · 2,922 drugs on file · formulary ID 00026191. Each drug links to its cost in every CMS PDP Region 01 plan.

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23 drugs starting with Q.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
QINLOCK 50 mg TabletRipretinib5Specialty Tier25%N/A
  • PA
  • QL 9 per 30 days
QUETIAPINE 100 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE 200 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE 25 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE 300 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE 400 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE 50 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE FUMARATE 150 mg Tablet, Extended Release4Non-Preferred Drug27%27%
  • QL 3 per 30 days
QUETIAPINE FUMARATE 150 mg Tablet, Film Coated3Preferred Brand25%25%None
QUETIAPINE FUMARATE 200 mg Tablet, Extended Release4Non-Preferred Drug27%27%
  • QL 3 per 30 days
QUETIAPINE FUMARATE 300 mg Tablet, Extended Release4Non-Preferred Drug27%27%
  • QL 6 per 30 days
QUETIAPINE FUMARATE 400 mg Tablet, Extended Release4Non-Preferred Drug27%27%
  • QL 6 per 30 days
QUETIAPINE FUMARATE 50 mg Tablet, Extended Release4Non-Preferred Drug27%27%
  • QL 6 per 30 days
QUINAPRIL 10 mg Tablet2Generic$10.00$30.00None
QUINAPRIL 20 mg Tablet2Generic$10.00$30.00None
QUINAPRIL 40 mg Tablet2Generic$10.00$30.00None
QUINAPRIL 5 mg Tablet2Generic$10.00$30.00None
QUINAPRIL AND HYDROCHLOROTHIAZIDE 10/12.5 mg Tablet2Generic$10.00$30.00None
QUINAPRIL AND HYDROCHLOROTHIAZIDE 20/12.5 mg Tablet2Generic$10.00$30.00None
QUINAPRIL AND HYDROCHLOROTHIAZIDE 20/25 mg Tablet2Generic$10.00$30.00None
QUINIDINE SULFATE 200 mg TabletQuinidine Sulfate Tablet3Preferred Brand25%25%None
QUINIDINE SULFATE 300 mg TabletQuinidine Sulfate Tablet3Preferred Brand25%25%None
QUININE SULFATE 324 mg Capsule4Non-Preferred Drug27%27%
  • PA

PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.